Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.81 / $62.29 / $79.73	Facility	26	$49.81	$62.29	$79.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $228.07 / $410.42	Professional		$174.81	$228.07	$410.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $62.26 / $98.00	Professional	26	$51.30	$62.26	$98.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $56.95 / $111.06	Professional	26	$45.56	$56.95	$111.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $153.04 / $243.56	Professional		$50.72	$153.04	$243.56
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $196.52 / $282.00 / $374.32	Professional		$196.52	$282.00	$374.32
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $56.38 / $60.33	Professional	26	$56.38	$56.38	$60.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.12 / $304.91 / $597.44	Professional		$168.12	$304.91	$597.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.87 / $71.23 / $123.58	Professional	26	$46.87	$71.23	$123.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $436.88 / $549.76 / $565.04	Facility	26	$436.88	$549.76	$565.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,293.84 / $2,362.66 / $2,362.66	Professional		$2,293.84	$2,362.66	$2,362.66
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $523.40 / $523.40 / $523.40	Professional	26	$523.40	$523.40	$523.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $244.63 / $322.91 / $472.08	Professional		$244.63	$322.91	$472.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.27 / $95.54 / $231.60	Professional	26	$75.27	$95.54	$231.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.23 / $166.42 / $334.08	Professional		$65.23	$166.42	$334.08
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $178.87 / $326.35 / $610.05	Professional		$178.87	$326.35	$610.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.42 / $71.23 / $123.00	Professional	26	$50.42	$71.23	$123.00
United Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $290.88 / $510.15	Professional		$203.72	$290.88	$510.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.86 / $64.95 / $111.57	Professional	26	$51.86	$64.95	$111.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.02 / $187.16 / $265.80	Professional		$167.02	$187.16	$265.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $49.42 / $56.95 / $78.59	Professional	26	$49.42	$56.95	$78.59